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CITY OF EVERETT <br />Application and Gas Installation Permit <br />All Work to be Donc in Accordance with r <br />City Ordinance <br />. ( � . � . � p . i � .�/ <br />[verett, W'ashin�ton....... �;:",.�?:�.4�!�... T�..., 19.t./... <br />, �f /� � <br />Locatiun.._l..i�:S �.:��/....✓��..... <br />.} / . <br />Owner...... � h f..t�t-� � . es✓ ....... <br />�. _7yl <br />Applicant....:.......l.T..� . ...... .....:....�:..... .. .. _:....:,. <br />Rough piping inspection X — _ <br />Pipe in excess of 60';-. �_- _- Gas Stoves _ <br />Gas refriyerators ;C�as warer heaters _ _ __. <br />Gas spacc heaters to 70,000 B.T.U. input _ <br />Cas space heaters over 70,000 B.T.U. inpu' <br />Gas fumaces to 400,000 B.T.U. input — __—____ <br />Gas furnaces over 400,QPO.,B�T.U. input <br />Ccnversion units fo 400,000 B.T.U. input — x-- <br />Cornersion units over 400,000 B.T.U. input <br />Small appliances - - -- _- ___ _ _ _ _ __ __. <br />,�, , <br />- -_ �-�_ _ __,. —.,,._,__ <br />, � �, <br />Call Back�lnspection _ Fee Paid �_,�_„_�;, <br />; ��">;--------- ---_...-- ---- -P`pF�icanl <br />� � �'�� � . ,� t�- 7� 4/� . .. . <br />Dy.., i��._.. - -I <br />f'lan§ appreved and Pcrmit grapted as mquested herein. <br />` ?� <br />�.:,1:';1�r�!t.f-. '.;f: Inspector <br />- '�j� <br />�,� i (. J.z- ` <br />/ <br />PERMIT \ :' l�l�!� <br />